Health ShortsDermatology
Acne: Fact and Fiction
About 90 percent of adolescents are affected by acne, characterized by blackheads, pimples and red bumps on the face, neck and shoulders. Caused by an overactivity of oil glands in the skin associated with changing hormone levels, acne can persist until age 20 or even 25 but rarely leaves any after-effects. Contrary to popular belief, the skin problems are unrelated to eating of fried foods, chocolate or any other food; sexual activity or personal hygiene.
[SOURCE: B.D. Schmitt, "Acne (for Teenagers)," Clinical Reference Systems, Annual 2001] Are We Getting Lax about Sun Protection?
Skin cancer can be prevented by avoiding direct sunlight as much as possible and by wearing protective clothing and sunscreen when venturing out. That message has been well publicized, but results of the National Health Interview Survey (NHIS) indicate that Americans have become lax about following these preventive measures. In 1992, the NHIS found that 28 percent of white adults were very likely to wear protective clothing, 30 percent made an effort to stay in the shade and 32 percent applied sunscreen. In the 1998 survey, those percentages had fallen to 27 percent, 23 percent and 30 percent respectively. Although women interviewed in 1998 were more likely to desire a tan, they were also more likely than men to practice sun-protective behaviors.
[SOURCE: "Americans Are Less Likely To Protect Themselves than in 1992," Cancer Weekly, September 18, 2001] Basal Cell Cancer on Face Is High Risk
Basal cell carcinoma, the most common kind of skin cancer, does not spread to other organs and is almost never life threatening. Yet when a basal cell carcinoma appears on the face, as it often does, it is considered "high risk." Left untreated or treated inadequately, it may damage the eyes, lips or nose and is difficult to remove with good cosmetic results. For best results, many doctors recommend Mohs micrographic surgery, a procedure in which the cancer is removed layer by layer, with each one examined under the microscope until the entire area is free of cancer cells.
[SOURCE: "Mohs Surgery for Basal Cell Carcinoma on the Face," Harvard Women's Health Watch," February, 2003] Don't Overlook Your Feet When Checking for Melanoma
One recent study found that the five-year survival rate for a melanoma on the foot or ankle was only 52 percent, compared to a survival rate of 84 percent for a lesion on the leg, knee or thigh. The authors theorized that the lower survival rate could be due to late diagnosis. A lesion between the toes or on the sole of the foot is easy to overlook. A melanoma on the foot may not have the appearance expected of a suspicious mole or it may be hidden or distorted by callused skin.
[SOURCE: Nancy Groves, "Don't Forget the Feet: Foot Melanoma Survival Rate Significantly Lower than leg, Knee, Thigh Cancers," Dermatology Times, November, 2003] Fake Tan Healthier than a Real One The prevalence of melanoma has increased steadily over the past 70 years. Whereas the lifetime risk for Americans in the 1930s was 1 in 1,500, the risk is now 1 in 75. Exposure to the ultraviolet rays of the sun is one of the risk factors for melanoma, the least common but most deadly type of skin cancer. Scientists believe the increased prevalence may be due to too much time spent in the sun, particularly during youth, combined with depletion of the ozone. Because of early detection and improved treatment, the mortality rate from melanoma has remained fairly stable. About 80 percent of melanomas are now detected while the cancer is localized and treatable.
[SOURCE: "Skin Cancer-Shedding Light on Melanoma," Harvard Women's Health Watch, September, 2001] For severe cases of acne, doctors often prescribe isotretinoin. Because of safety concerns, however, primary care physicians often refer these patients to dermatologists who are generally more familiar with monitoring requirements. Major birth defects occur in 25 to 30 percent of fetuses exposed to isotretinoin. The drug is also associated at times with psychiatric problems and suicide.
[SOURCE: Sarah Evans and Heather McNeill, "Quantum Sufficit: Just Enough," American Family Physician, November 1, 2003] Know UV Index Before Venturing Out
Any time you plan to be out in the sun, listen for the UV Index on the local weather report...and use sunscreen accordingly. A standardized measure of UV radiation levels, the Global Solar Ultraviolet Index was developed by the World Health Organization and recently adopted by the United States in order to raise awareness about the importance of protecting the skin and eyes against ultraviolet radiation.
[SOURCE: Mary Ellen Schneider, "Global UV Index," Skin & Allergy News, August, 2004] Lycopene Promotes Healthy Skin An American living in 1935 had a lifetime risk of 1 in 1,500 of developing melanoma. A comparable person in, 2003 had a 1 in 67 risk. Scientists attribute most of that increase to overexposure to ultraviolet radiation. Although there is more effective screening in the United States today than in 1935, melanoma rates have also been increasing rapidly in countries where there is still little screening or education.
[SOURCE: Mike Wyndham, "Pharmacy Update: Malignant Melanoma," Chemist & Druggist, February 14, 2004; Mitchel L. Zoler, "Lifetime Risk of Melanoma in U.S. Increased to 1 in 67: Incidence Rates Soar," Family Practice News, August 1, 2003 "Shedding Light on Melanoma," Harvard Women's Health Watch, September, 2001] Melanoma Invades Dark Skin Too
Melanoma occurs about 10 times more frequently in white than in black Americans, but African Americans and Hispanics should not ignore warnings regarding exposure to sunlight, use of sunscreen and skin self examinations.
Melanoma and other skin cancers are more likely to be discovered at a later date in dark-skinned persons, and the survival rate is significantly lower. One study found that for blacks 40 percent of melanomas were on the feet and only 33 percent on sun-exposed skin.
[SOURCE: Michele G. Sullivan, “Dark-Skinned Patients Are Still at Risk for Skin Cancers,” Family Practice News, May 1, 2005] Doctors are reporting a sharp increase in non-melanoma skin cancers among young adults. While these cancers are readily treatable and not as dangerous as melanoma, they have previously been considered a problem mainly for persons age 60 and over.
A person who develops one non-melanoma tumor has a 50 percent risk of having a second within two to three years and a 75 percent risk of developing a third.
The major risk factor is exposure to ultraviolet rays, and 80 to 90 percent of non-melanoma skin cancers develop on sun-exposed areas of the body.
[SOURCE: J. Raloff, “Sun Struck: Data Suggest Skin Cancer Epidemic Looms,” Science News, August 13, 2005]
Skin Color Affects Sensitivity to Sun
Response to the ultraviolet radiation of sunlight may vary more than 100-fold between persons of different skin pigmentation, according to a study published in the American Journal of Human Genetics.
At greatest risk of skin cancer are fair-skinned individuals of northern European descent living in sunny areas. Even among such persons, however, response to ultraviolet radiation may vary four- to five-fold between individuals or even with the same person at different body sites.
[SOURCE: Jonathan L. Rees, “The Genetics of Sun Sensitivity in Human, (Review Article),” American Journal of Human Genetics, November, 2004] Some Drugs Increase Sun Sensitivity There's no question that sunbathing or lying under a tanning lamp will significantly increase your risk of skin cancer, but some exposure to sunlight is healthy. Recent studies conducted at the National Cancer Institute found that individuals living in sunny areas and working outside had a significantly reduced risk of dying from breast, colon, prostate and ovarian cancer. Sunlight provides about 90 percent of the average person's vitamin D, and researchers believe that this vitamin may prevent malignant cells from growing and spreading.
[SOURCE: Marnie Ko, "Go Ahead, Catch Some Rays; New Studies Suggest Heliophobic North Americans Should Stop Being So Afraid of the Sun," The Report Newsmagazine, October 7, 2002] Sun Exposure Increases Moles, Risk
The more moles you have on your body, the greater your risk of developing melanoma, the most serious type of skin cancer. And studies indicate that in children exposure to high-intensity sunlight increases the number of moles. One study of German children, aged two to seven years, found that the number of moles on a child increased with age and that the increase was strongly associated with the number of holiday days spent in areas with intense sun exposure.
[SOURCE: Mitchel L. Zoler, "Intermittent, Intense Sun Triggers Nevi Formation," Skin & Allergy News, July, 2003] Sunscreen: Don’t Go Out Without It
Even in small amounts, sun damages the skin, causing premature wrinkles, sags, sun spots and skin cancer. Various wave lengths of ultraviolet radiation have different ways of harming skin cells. Radiation is believed to release oxidants which damage the collagen fibers and elastin that give the skin strength, firmness and elasticity.
To protect the skin, dermatologists recommend the use of sunscreen with an SPF of 15 or greater that protects against both ultraviolet A and ultraviolet B radiation. About two tablespoons is usually sufficient to cover exposed areas of the body. It should be re-applied every two hours or after swimming.
[SOURCE: “Sun Is the Skin’s Greatest Enemy,” Harvard Women’s Health Watch, April, 2002] UV Rays–The Good and the Bad
Ultraviolet radiation has been implicated as a major cause of most skin cancers, cataracts and premature aging of the skin. At the same time, death rates from prostate, ovarian and other cancers are only half as high in sunny areas such as Arizona compared to cloudy northeastern states. According to one analysis, too little exposure to ultraviolet B radiation contributes to the premature cancer deaths of 21,700 whites and 1,400 blacks each year.
This increased cancer risk is believed to be due to a deficiency of vitamin D, which is manufactured by the body in response to exposure to ultraviolet B radiation. Only a small amount of sun exposure is needed, however, and vitamin D can also be obtained from diet and supplements.
[SOURCE: W.B. Grant, “An Estimate of Premature Cancer Mortality in the U.S. Due to Inadequate Doses of Solar Vultraviolet-B Radiation,” Cancer, 94(6), 1867; Emil Vernarec, “Sun Exposure, Vitamin D, and Cancer Deaths,” RN, November, 2002] | ArchiveAIDS & HIV |
The information on this site is intended to increase your awareness and understanding of specific health issues. It should not be used for diagnosis or as a substitute for health care by your physician. | |
